# LASER VEIN INSTITUTE SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902995210
- **Authorized official:** DOMINIC J TOLITANO MD (PRESIDENT / OWNER)
- **Authorized official phone:** (630) 860-0035

## Contact information

- **Practice address:** 311 N WALNUT AVE, SUITE 100, WOOD DALE, IL 60191-1566
- **Practice address phone:** (630) 860-0035
- **Practice address fax:** (630) 860-5262
- **Mailing address:** 777 OAKMONT LN, SUITE 1600, WESTMONT, IL 60559-5511
- **Mailing address phone:** (630) 789-2550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | IL | Yes |

## Other

- **Enumeration date:** 10/12/2006
- **Last updated:** 02/14/2008